Hi Huff. I feel you... I started treatment 5 yrs ago. Some has been "school of hard knocks", some has been deliberate training. My fears are similar to yours... rejection and criticism, as well as sexual issues. The sexual issues were "easy" since they're so specific. The others, harder....
Here are a number of things that have helped me. I have used them incrementally - One. At. A. Time - over the past 6 years... don't rush yourself, try one thing until it becomes natural and then add another. One thing you probably often feel is a sense of "danger" and "I have to fix this" but you can't just fix it. Its very much a process. It was a huge help in my recovery when I was able to really learn and believe that. My best help so far has been DBT (see below) and a no-nonsense friend who put up with my tantrums and taught me new ways to think (basically, mindfulness) and never let me believe the lie that I am powerless to change the way I think and feel.
I am the type of person who deliberately practices hard things, and everything is an opportunity to re-learn the reactions I have to things. I examine every reaction and learn to re-contextualize the trigger because I'm out of the abusive situation now. Some things that have helped are a) dance lessons b) art and music c) new relationships (where I took full responsibility to not repeat past mistakes). I actively work on posture, mindfulness in daily life and in meditation, routine. And yes, antidepressants are very helpful, especially when learning new skills.
Right now I'm also taking a class called DBT (dialectical behavioral training). it can be very hard at first, as you become more aware of your reactions. When we first studied distress tolerance, they said "this is for crises"... and I said, "I have at least 2 crises per day!! What are you talking about??!" None the less - the skills that are taught are very effective, fairly easy to wrap your head around, and "relatively" easy to implement one at a time and incrementally make changes to your reactions. I highly recommend it, especially in a group format where you can talk over your experiences and applications of the skills. There are also books - Marsha Linehan is the original developer, and DBT has become the gold standard for many maladaptive psychologies (such as PTSD is).
At first, I did a lot of "Oh! that's not normal?" and after a while, my brain started automatically telling me (in times of stress), "Wait! I have a DBT skill for that!" Some days it saves my butt kind of automatically. Other days, like today, something triggery happens and I sit down with my book and seek out a specific skill and journal how I would do it differently if I could, or what the next steps might be.
Beyond that... I had some EMDR treatments too. PTSD is basically learning "wrong" reactions to stressful situations (often because you couldn't fully wrap your head around the situation.) EMDR re-trains your mind to remember the trauma as an outsider, not as a victim... it's extremely effective, although it's also pretty intense - I slept for a day and a half after my last treatment. But, if you're in a stable therapeutic relationship and EMDR becomes an option, it's a good way to retrain your memories and reactions, and for me, also informed how I go about "retraining" my own mind on a day to day basis.
Other, immediate ideas:
1. Always, if possible, stop and ask a good "why" question before responding to things. With my kids, I trained myself to ask "What do they really need?" before choosing how to react to something they were doing (that was my first success iin this area. )
2. Cope ahead: if you can identify a trigger, journal or role play in your mind how it would go if you were not a PTSD sufferer - what does it really mean? What is the worst case scenario? Is this really such a bad thing? Is thia going to matter tomorrow? Next year? In 10 years?
3. Enjoy this specific moment: practice just enjoying one thing at a time. Triggers are often (not always) related to fears of the future or repeated past actions. If you're making dinner or taking a walk or playing poker or riding the train... focus on your five senses and let any thought or fear unrelated to this very minute pass by. Sometimes, I jot down my anxieties if they're strong (because they're rooted in a belief) and then write the antithesis (I'm afraid I'll fail. But, I've made this recipe many times and have no reason to fear that.) Then just move on and go back to what you were doing.
4. Slow down: this is similar to number one... just, train yourself not to react/act... it sounds trite and hard, but it's very possible. Specifcially notice your five senses: what do I actually see, hear, smell, feel (touch), taste... then make a decision based on that sensory information.
5. in relationships: choose a canned cue that gets people to give you the space to figure it out. my fiance had some combat PTSD so he understands what happens when a conditioned response triggers, so I just say, "I'm in the hole" and he understands I need to take some time to try and work it out, and that if I can't immediately I'm likely to be "off" - I have to take responsibility to not be a maniac, but I don't have to force myself to pretend to be cheerful, either.
6. And finally: be willing to cry it out. All these steps and ideas can be very very painful. And that's OK. my therapy has taught me one of the keys to un-programming PTSD reactions is truly experiencing the pain and processing it fully... which then files it away in my brain correctly. Occassionally (if at all appropriate) grab your journal or favorite chair or just go to bed and process, as if it were the first time. Really feel it, really process what it all means, what is your responsibility and what isn't, some of the why's (if appropriate), all of the "this sucks and totally isn't fair..." but, sometimes life sucks, and finally "but I'm stronger than all of it. Today I'm a grown up and I will beat this."
Speaking of which, my other favorite book recently is Nathaniel Braden regarding Self Esteem - he is a psychologist and reseracher, not a positive-affirmation guru. He gives some great practical advice on how to build true self-esteem, which helped me tremendously in this process.
So, this turned out to be a lot. Dont be overwhelmed. One day at a time, one thing at a time. Really enjoy the good moments. :) (and thanks for this opportunity... now i remember what i need to do for myself today. Keep that in mind - it can be hard to get out of your head and remember what to do, and this is how i do that. ;-) ) Take good care!!
